Thrive Leadership Center - Application

I am applying for

Select a track: *

William Jessup Confirmation (For Tack 2 Applicants Only)

Please confirm that you:

Have applied to William Jessup University

Have been accepted to William Jessup University

Please select which ministry you are applying for:

Personal

First name: *

Last name: *

Address: *

City, State, Zip Code: *

Phone: *

E-mail: *

Are you a citizen of the US? (If not, you may not be eligible to participate in THRIVE Leadership Center): *

Yes

Birthday: *

Marital status (if married, how many years?): *

Have you ever been convicted of a felony?: *

If yes, please explain:

Education

High school: *

Address: *

Years attended: *

Post-high school:

Address:

Years attended:

Degree/Certificate:

Family

Name of father:

Address:

Name of mother:

Address:

Name and ages of any siblings:

Church

Name of home church: *

Denomination:

Address:

City, State, Zip Code:

Phone:

Name of senior pastor:

Name of youth/college pastor:

How long have you attended this church?:

Are you a member of this church?:

List any ministries you are presently involved with at your church or in your community:

Faith

How does following Jesus shape your life right now?: *

What are you praying will happen in your life while you are part of the Thrive Leadership Center?: *

References (Please list two references, non-family, who know you well.)

Name: *

Relationship: *

Address: *

Phone: *

Name: *

Relationship: *

Address: *

Phone: *

Medical Background

How would you describe your health?:

List any allergies:

List any physical limitations:

List any medications you are currently using :

Have you ever used illegal drugs? If yes, list date of last use:

Have you ever smoked tobacco? :

Have you ever drunk alcoholic beverages? If yes, list date of last use:

Do you have health insurance? If yes, please provide carrier and policy #:

TCI Membership

Become a TCI Member and receive all these benefits. Join Now.

Change the World - One Child at a Time.

When you sponsor a child, you are linked with one particular child who will know your name, write to you, and treasure the thought that you care. He or she will pray for you often and write to you. Your tax-deductible contribution of just $38 a month connects your child with a loving, church-based child sponsorship program that provides:

Food and clean water Medical care
Educational opportunities
Important life-skills training

Most important of all, your sponsored child will hear about Jesus Christ and be encouraged to develop a lifelong relationship with God.

Sponsor a Child Today

Thrive Leadership Center - Application

TCI Membership

Change the World - One Child at a Time.

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